


\ 



/ 



PUMWMMMWMWWMMMWWMM^ 



The Conservation 



OF THE 

HEALTH 

TEETH 

VOICE 

HEARING 

and 

SIGHT 




REAVES 



^^-^^^^^^^^mmmmmmmmwrfMi 



p^ 



« 



©C1,A315575 



The Conservation of The 

Health, Teeth, Voice, Hearing and Sight 

BY 

WM. PERRY REAVES, M. D. 
II 

A* A» 

HTHE lantern slides used in illustrating these two lectures are made from 
the same pictures as the half-tone illustrations which appear in this 
booklet. 

in For proper success in presenting these lectures to the audience, the lec- 
turer should thoroughly familiarize himself with the subject matter, and 
especially should he have his long pointer touch the very places indicated 
by the asterisk (*) at the moment they are mentioned. Therefore some 
practice on the canvas with the operator should be had so that there will be 
no confusion before the audience. 

€[[ The slides, which should be numbered the same as the figures, are in- 
dicated by slide "No." in the lecture to prevent confusion by the operator 
in manipulating the slides in the lantern. The operator should have them 
numbered on a card in the order to be used or repeated. Then the lecturer 
can suggest the next slide by tapping the floor with his pointer. 
•H A 2 to 6 C. P. electric light lighted by the house current or a small bat- 
tery, covered by a hood or a cone to throw light on a space the size of this 
pamphlet, enables one to see his lecture for reference at any time. A card 
in front of the light prevents its reflection to the audience. 



Copyrighted 1912 

by 

WM. PERRY REAVES, M. D. 




Privately Printed. 






PREFACE 




■^ HIS illustrated booklet is the result of scientific work 
which has proven to be effective in the Conservation 
of Health, Teeth, Voice, Hearing and Sight. 
€11 When it is once realized that nearly every defect 
if taken in time can be remedied, it is little short of 
criminal negligence if remedial influences are not in- 
sisted upon. 

fH The child may be saved untold sufferings and be 
developed into a useful and happy citizen, if parents and teachers can be 
duly awakened to their responsibilities in this matter, nor should this sub- 
ject be of less interest to adults. This booklet may therefore be used in the 
giving of stereoptican lectures to show the need of more enlightment on 
these most vital subjects. 

•H Stereopticon slides for lecturing purposes can be secured at a normal 
cost and will be found a most interesting medium for conveying this 
knowledge. 

€]] These two lectures are the synopses of papers and lectures given before 
medical societies, before county institutes for teachers and also before the 
teachers and senior students of the Training School for Teachers at the State 
Normal and Industrial College of North Carolina at Greensboro, N. C, 
where by inspection and treatment of the children they were worked out to 
a practical basis. 

<11 The figures which illustrate mouth breathing, stooped-shoulders, V- 
shaped arch, irregular and crowded teeth, are from photographs taken from 
life. The figures to illustrate adenoids and tonsils; the anatomy and physi- 
ology of the ear; the working of the eyes and their muscles; were made 
from anatomical drawings under the directions of the author, 
<| Many children enter school at the age of six so defective that they are 
in the first grade two or three years; many others become defective, which 
impedes their progress. 

•H It has been my endeavor to first get the audience or reader to appre- 
ciate the normal person and the relative importance of the eight fundamen- 
tals; then they, by comparison, grasp more easily the defective child and 
the cause of the defect. 

<11 I have found it unwise to crowd both lectures into one and therefore 
advise that they be given in two lectures, especially to students of univer- 
sities, normal schools and summer schools for teachers. When limited in 
time each picture may be used by itself for a talk of from one to three minutes 



WM. PERRY REAVES, M. D. 



Greensboro, N. C, U. S. A. 



Lecture No. 1. 

Health 



The importance of the conservation of the upper respiratory tract which 
consists of the nose, the naso-phnrynx nnel the larynx can scarcely be 
overestimated as in their preservation is likewise the conservation of the 
lower respiratory organs— the lungs which are connected to the larynx 
by the trachea, for through these is supplied air, one of the three essentials 
to groiv a strong body. 

In this progfressive age we find many processions marching under 
noble banners representing different associations to improve the health, 
intellect, and happiness of the hnman race. Congress champions the 
pure food law. The State Board of Health and its subdivisions are the 
guardians of our health. Our edireational institutions, which have been 
and still are intellectual dispensaries, are now becoming, by being wedded to 
bureaus of health, di.spensaries for health as well as for intellect. The asso- 
ciations to prevent child labor and other health and civic organizations too 
numerous to mention have made great progress in working out and improv- 
ing health conditions. 

Any government, corporation, association or educational system, ad- 
vising or educating its subjects must treat them collectively; therefore, it 
cannot meet the needs of each individual. Instruction coming from so 
many different sources dealing with the subjects, health, and education, mnst 
jiecessarily overlap the two. Let us reverse the order of treatment, put the 
individual in front of us, and test his physical endurance and intellectual 
capacity by the eight fundamentals : If he is found to be normal and pro- 
gressive, teach him to maintain these eight fundamentals; if defective, 
show him the cause, reason Avith him, convince him that his physical and 

SLIDE No. 1.— 



Fig. 1. 



Eight Fundamentals: 



Physical 



Intellectual 




Sight 
Hearing 
Smell 
Taste 
and Touch 



Are the essentials to grow a strong 
body and a strong mind. 



mental forces are not up to normal because one or more of the eight fnn 
damentals are defiicient and may disturb the equilibrium of the whole. 

The Eight Fundamentals* : The Physical'^ : Air*, AVater* and Food*. 
The Intellectual'^ : Sight*, Hearing*, Smell*, Taste* and Touch* are the es- 
sentials to grow a strong body and a strong mind from and through which all 
physical and intellectual life is developed. To neglect, cripple or destroy 
any one of these, is taking from the individual an asset which is one of the 
fundamentals necessary to grow a strong body and a strong mind. 

Look at the steam engine ; the fireman must be an expert in supplying 
the three fundamentals — air, water, and fuel to generate heat, steam and 
power. What happens if he cuts off part of the air? Partial oxidation of 
the coal, which is the engine's food, the weakening of its heat and energy, 
and thus the train is delayed, or sidetracked, and the passenger does not 
rea;ch his destination on time. So it is with this little human engine, the 
body, that is dependent upon both quality and quantity of air*, water* 
and food*. Without all these in due proportion, it weakens both its physi- 
cal and mental abiJity till it can only work on the lower grades or is side 
tracked short of its destination. Then who are to be the engineers of the 
bodies of our little people, 

SLIDE No. 2.— 




Fig. 2. 
that they may breathe fresh air* through a normal healthy nose, drink 
pure water* from a clean glass, chew good food* with good teeth? Fresh 

(4) 



air*, pure water*, good food* — these are the three essentials that contain the 
dynamic forces from which through a process of digestion and assimilation 
the human system is grown, 

SLIDE No. 3- 



Touch Area 



V 



Inh/lectua/ 
Area \ *- 



I Smell dni Tdste/Jneds 

/] near center of Brain 

Hearing ^rea 




Fig. 3, dissected to show the relations of the working of the spe- 
cial senses is much like the telephone. The eye, ear, nose, mouth and 
hand are the phones that gathers information for the brain, the central 
station; the nerves are the wires carrying the information to the sight, 
hearing, smell, taste and touch areas. These areas are the switchboard 
that receive and give the messages to the intellectual area. 

which contains the brain*, the potential force that rules the world. The intel- 
lect, (intellectual area*), an intrinsic power, king over all, is the product 
of the brain* developed through the five special senses — sight, (eye*) ; 
hearing, (ear*) ; smell, (nose*) ; taste, (mouth*), and touch (hand*) ; with 
the cranium or (skull*) for their chemico-psyehologicaP laboratory sup- 
ported in a material way by the digestive tract, where food in solution with 
water, is fanned into slow oxidation by the oxygen of the air breathed into 
the lungs and diffused into the system by the circulation of the blood. By 



(1) Every impression or idea conveyed to the brain through the 
five special senses produces a chemical change in the brain cells and a 
psychological act in analyzing the impression for future reference, 
(memory or knowledge). 

(5) 



the mutual co-operation of these two, the brain and digestive tract, is de- 
veloped the physical and intellectual being, under the wise couneil and pro- 
tection of the physician. The training of the mind through the five special 
senses is accomplished by the parents, the teacher, the child's suroundings, 
and the good influence of the preacher. This is a combination that is har- 
monious, this is real team work, to develop a well-rounded physical, mental 
and moral person. 

SLIDE No. 4— 



>I'^^ 







•j^ - 





'jVn.'t 



■; ■T^i^ :■;: ''5^'i^4 



Fig. 4. ' 

Now we will inspect the iudividual in the light of the eight funda- 
mentals — much like the photographer inspects the negative- — as it were, to 
look through the individual for hereditary or acquired defects. 

These children greet you with the Hapsburg lips (adenoid facies and 
mouth breathers*), acquired defects shown on the negative from which these 
pictures were made, that could not be removed by the photographer, which 
gives to each one in the picture a dull, listless and vague expression. There- 
fore the artistic touch of the surgeon's knife was required to remove the 
causes before the photoprapher could take a negative without these defects. 
This is a group* of children from one of the Guilford County Graded 
Schools that demonstrate certain physical defects, the results so often 
brought about by violating nature's laws. These children who were mouth 

(6) 



breathers, especially at night, have paid a double or triple penalty because 
they could not i-et sufficient air through the nose to supply the system with 
oxygen, thus disturbing, by the lack of sui^cient air the three essentials — 
air, water and food, necessary to grow a strong, erect and well developed 
body. 

SLIDE No. 5.- 




Fig. 5. 

These children are the same as Slide No. 4— three to five months 
after the operation for the removal of adenoids and tonsils, all gained in 
weight. No. 4* gained from twelve to fifteen pounds in three months. No. 
1* paid all the penalties of insufficient air — lowered vitality, stooped should- 
ers, pigeon chest, V-shaped arch crowded, irregular and decayed teeth. 
(Illustrated in figures No. 6, 7 and 8). 

The diagnosis could easily be guessed by their typical adenoids facies*. 
The rest of the group suffered in a less degree. None of them had any no- 
ticeable ear defects, all were mouth breathers, with excess of secretions from 
the nose and throat, (sniffles), caught cold easily, had nasal voice, adenoitl 
facies, snored at night, and slept badly for want of air. Fig. No. 5 compared 
with Fig. No. 4, is conclusive proof that obstructions in the upper respira- 
tory tract by adenoids and tonsils were handicaps to their health, growth 
and preparation for a successful career. The removal of the obstructions 
has re-established the equilibrium of air, water and food necessary to grow 
a strong body and mind (l)rain), and now they are in the race of life to win. 

(7) 



SLIDE No. 6—=* 




Fig. 6. 

This little fellow who is six years old stands in the attitude of an 
interrogation point, which, when correctly interpreted asks the question : 
' ' Shall not the children have without obstruction the only one of the three 
essentials, namely, air, which contains oxygen that is free for all; which 
is not subject to tax, or to an investigation by Congress in the upward flight 
of the cost of living, but which is the gift of spring and summer when sun- 
shine and rain cause plant life to take from the air Carbon-dioxide (CO ^\ 
and give in return free oxygen?" 

Adenoids and tonsils are modified lympathic glands and are therefore 
considered aids to the lympathic system. They should not be removed unless 
diseased or hyper trophied (enlarged) causing obstruction in breathing, 
ear troubles, sore throat, catarrh and colds. 

SLIDE No. 7.— 

No. 1* with a heavy head and obstructed nose, stoops to breathe — 
trying to get enough air into his Jungs that the blood in the lungs may ex- 
change its Carbon-dioxide (CO-), the waste product of metabolism of the 
system for the oxygen in the air, to make the venous blood a scarlet red 
as it carries the oxygen to the tissues to aid in the process of metabolism 
where the carbon of the food unites with the oxygen turned loose in the 
tissue and is carried back to the lungs as Carbon-dioxide. His stooped po- 
sition* is to enable him to breathe with least resistance, by depressing the 
base of the tongue* which pulls the epiglottis* forward and puts the larynx* 

(8) 



Nu.l i 



of Ptk's 




No. 2 






Tons/I i 



Obsiruction in 
Upper Respirdtory Tmi 




I Up^er Bespmiory Trad 



Fig. 7 — Side view showing half sections of head and neck.. No. 
1 shows the hypertrophied adenoids and tonsils, causing obstruction 
in the upper respiratory tract. No. 2 shows the normal adenoids and 
tonsils and the normal upper respiratory tract. 



more in line with the mouth* thus giving a "straighter" channel for the air 
through the mouth to the larynx. The base of the tongue* being pulled 
downward and forward increases the air space between the palate* and ton- 
sils* above and the base of the tongue* below. With the tongue* the epiglot- 
tis*, which normally would be in the air channel during mouth breathing, is 
depressed and pulled forward. No. 2* has the adenoids* and tonsils* 
of normal size, is well developed, stands erect*, with free chest expan- 
sion*, normal arch*, good teeth*, eustachian fossa clear,* epiglottis* in 
natural position, and breathes freely and easily through the nose*. Mouth 
breathing from obstruction in the nose is not so conducive to stooped should- 
ers as when caused by adenoids and tonsils, because the space above the base 
of the tongue is not obstructed then as it is when there are adenoids and 
tonsils. The causes are plain, the physical defects are apparent, the remote 
effects can easily be seen in No. 1*. 

Any obstruction that prevents normal breathing through the nose*, 
whether by a broken nose or by adenoids* just back of the nose, usually by 

(9) 



irritation, causes an excess of secretions of mucus and phlegm in the nose 
and throat. This condition requires an excess of kerchiefs or clearing the 
throat during the day. When asleep the secretions are often swallowed, 
causing indigestion, or when inhaled and aspirated into the lungs, often 
causing coughing. Added to this, air breathed through the mouth does not 
contain the proper amount of heat and moisture to keep the lungs in the best 
condition. More than 90 per cent of all ear trouble comes from nose and 
throat trouble, and from want of proper ventilation through the eustachian 
tube (which will be considered later). 

Teetli 

The normal upper respiratory tract is the first essential for the conservation 
of the teeth, to prevent the deformities of the face luliich often result from 
nasal obstruction during the growing period of the child. 

These deformities of the face are known as adenoids facies, fish-mouth 
with a dull expression and are the result of mouth breathing, (insert Slide 
No. 8 for a moment) which develops the V*-shaped arch (high arch of the 
hard palate) of the upper jaw which becoming narrower from side* to side* 

SLIDE No. 8- 



V shaped Arch Normal Arch 

and irregular Teeth. and 




n 



(gWev iWI'i S y 



Caused by mouth breathing. 

The result of Ifypeiiwphied 1 eeth. 

Adenoids and Tonsils. 

By courtesy of Or Beih. 



(Schematic) 



Fig. 8. 

crowds the teeth* and pushes the front teeth* forward, known as a fish- 
mouth* (insert Slide No. 7 again). The condition is the result: first, of les- 
ser pressure of the upper lip*, which is raised and does not cover the front 
teeth; second, of increased pressure at the corner of the mouth* which is 

(10) 



pulled in when the month is open; third, of lack of pressure of loAver teeth* 
against upper teeth*, which iti the shut month tends to widen the upper jaw ; 
fourth, of lack of pressure of the tonsne upward and outward against the 
upper teeth which is the tongue \s natural position in the shut mouth, the 
tongue in mouth breathers being held figainst the lower teeth*. Crowded, 
irregular and protruding upper teeth are hard to keep clean; and in mouth 
breathers are not kept moist and lubricated with the saliva, nature's medium 
to preserve them, but are exp'osed to the eo'd in winter and in botli winter 
and summer they are dry and covered by a tenacious coating which is really 
the waste of the expired aii-, which anyone can demonstrate by breathing 
upon a cold glass. These conditions ])lus the dust in the air and the decom- 
position of this sediment are the greatest of all primary causes of decayed 
teeth. 

Voice 
The )ioriii(iI upper respiratory tract is also Ihr first essential in the eonserva- 
tion of the mecha7iism of the vocal apparatus. 
The lower respiratory tract are the lungs which are reservoirs for 
the air that plays upon the greatest instrument known, the vocal cords, 
(Fig. 7, No. 2, Larynx* arrow indicates position of vocal cords in the 
Larynx*). The ])alate* is the soiuiding board. The na.so-pharynx*, the 
nose* and its accesory cavities and the mouth are air chambers which Te- 
inforce the sound waves produced by the vocal cords*, thereby increasing 
their resonance, giving them quality and volume. The tongue*, the 
teeth* " and the lips* are the keys to clear pronunciation and articu- 
lation. The anterior* and posterior* pillars of the tonsils* which unite 
above the tonsils become the soft palate*. To its center and posterior 
edo-e is the uvula*. The muscles in the pillars of the tonsils are very 
active during talking and singing. They pull the palate backward and 
close the space between the pharynx, back part of the mouth, and the post 
nasal space, thus directing the sound waves through the mouth* ; or they 
depress the palate* against the base of the tongue*, which is raised, thereby 
directing the current of air through the nose*. Between these two ex- 
tremes the palate*, which is the rudder to the out-going sound waves, be- 
comes the musical director of the voice, by directing enough of the out- 
going current of sound waves through the nose* where the resonance is in- 
creased to give the proper tone and quality to the pronunciation and articu- 
lation as the words are completed by the tongue*, the teeth* and the lips*. 
This is the well-modulated and harmonious voice that rules, sways and wins 
the world. How much like the violin is the human voice ? The vocal cords* 
are the violin strings; the current of air from the lungs is the bow; the 
soft palate* directs and modulates the sound waves much like the 
iingers upon the strings; the uaso-pharynx, the nose and its accessory cavi- 

(11) 



ties and the mouth are air chambers to re-inforce the resonance, as does the 
body of the violin. 

How different the voice with obstructions in the upper respiratory 
tract, whether in the nose*, back of the nose, as adenoids, or from large 
tonsils* widening their pillars and pushing the palate* up, lessening the 
post nasal space* and also the movement and elasticity of the palate*. This 
causes the nasal voice which is dull, muffled and without resonance and in 
which letters like B and M are indistinct for want of nasal resonance. Such 
a voice is just about as musical as violin strings on a board, played by a one- 
armed musician. These people improve the resonance of the sound waves by 
raising the palate* thus directing the sound waves through the mouth. This 
increases the space in the mouth and is used as an auxiliary resonance cham- 
ber, partly compensating for the loss of the nasal resonance. 

SLIDE No. 9. 



No.l 



Sepftim 



Middle £dr (Enldr^ed) jS^^^ t> 

Incus / _ i J* %3- NNal leus 
Slapes 



Cochlea 




These Pictures show the 
Normal Upper 'Respiratory Trdcf. 
Eusf'hn Tube end Middle Edr. 



Fig. 9, No. 1, side view of month, tongue, post nasal space, eusta- 
chian fossa, normal adenoids and tonsils, palate, epiglottis,, larynx (arrow 
points to vocal cords). No. 2, front view cross section of external, mid- 
dle and internal ear, tube, (eustachian) palate, normal adenoids and 
tonsils-. 

Hearing 

The norm'al upper respiratory tract is also the first essential in the conserva- 
tion of the mechanism of the drum and ossicles of the middle ear. 

(12) 



The ear, the organ of hearing, is a receptive musical instrument, the 
voice is a productive musical instrument which could not be appreciated 
were it not for the ear. 

Corti, observing that nuisical instruments of the same key would 
vibrate in sympathy with each other, was the first to catch the 
true inspiration of the secret of hearing, advancing the hypothesis that the 
ear* is a receptive musical instrument, proving his hypothesis by discover- 
ing the cells of Corti in the cochlea*, which he likened to the keys of a piano 
and its only performer is the delicate touch of the amplitude of the sound 
Avaves playing upon the drum*, which transmits the vibration through the 
ossicles (Malleus*. Incus* and Stapes*) to (ho organs of Corti in the coch- 
lea*, where thoy are analyzed and the result sent to the hearing center by the 
auditory nerve, their interpretation there becoming the sense of hearing. 
So sensitive are the mechanical workings of tbe drum* and ossicles (Mal- 
leus*. Ineus* and Stapes*) that by the droj^ping of a pin ui^on the floor, the 
little sound waves put the ossicles in motion and we hear. This is made pos- 
sible by the drimi* which separates the external ear (ear canal*) from the 
middle ear*. The drum* curves gently inward and is held in this positio?] 
by the tensor tympani muscle, (smallest muscle in the body) which takes up 
the slack of the drum*, and makes it a sentinel to catch the sound waves. 
Although the hearing center may be asleep, tho little sound waves are carried 
from the drum* to the cochlea by the ossicles* (the smallest bones and the 
only bones in the body covered by mucous membrane) making their joints 
free and easy to move. This delicate mucous membrane covering the ossicles 
is protected by the drum* from dust-laden, dry and cold air. which would 
injure or harden the mucous membrane, and stiffen the joints of the ossicles. 
There are three functions of the drum : first, to make the outer wall of 
the middle ear*; sescond. to protect the mucous membrane of the middle ear 
from raw air; third, to receive and duplicate the sound waves for the ossi- 
cles. Therefore the middle ear is a protective chamber for the ossicles and 
muscles. Tt is ventilated through the eustachian tube*, establishing an 
equilibrium of air pressure on both sides* of the drum*, giving the drum 
absolute freedom, and it is as sensitive to sound waves as if suspended in 
the air. The middle ear must be ventilated not simply with air. but with 
moist warm air to protect its delicate mucous membrane lining the cavity 
and covering the ossicles. Nature's only available supply is by tapping the 
upper respiratory tract by an eustachian tube* and which opens an avenue 
through which more than 90 per ct. of ear trouble and deafness are acquired. 
Thus you see that the key to protection or destruction of the hearing is in 
the upper respiratory tract. The first essential to maintain the acuteness 
of the hearing throughout life, is the breathing through a normal, healthy 
nose*, which moistens and warms the air for the ventilation of the middle 

(13) 



ear* through the eustachian tube*. This ventilation is not continuous, but 
intermittent. During the act of swallowing, the throat muscles open the 
tube and the air pressure is kept the same in the middle ear* as on the out- 
side of the drum*. 

SLIDE No. 10.— 






Rfirscfed for Drm 






I 



Obsfmcfms m Upper 
md Eusfachidn Tube 




sn^ Umk 



wdtory Tract. 
Defedm Hedrin^. 



Fig. 10, No. 1, side view of high areh of the liard palate (V-shaped 
arch) of hypertrophied tonsil and adenoids. No. 2, front view of cross 
section of hypertrophied tonsil and adenoids with catarrh of the eusta- 
chian tube and the middle ear the cause of the retracted drum. 

"Obstruction in the upper respiratory tract," may be catarrh of 
the nose, a broken nose, growths in the nose or adenoids* just back of the 
nose. The tonsils* with few exceptions are the only obstruction to be con- 
sidered in the throat area. Any obstruction in the nose causes pressure on 
the surrounding tissue, especially on the opposite side, producing pressure 
against the mucous membrane ; this pressure irritates the mucous membrane 
causing congestion; congestion of the mucous membrane is catarrh of the 
mucous membrane, and catarrh of the mucous membrane of the nose anJ 
throat practically always has an ex!cess of secretion from the nose and 
phlegm from the throat. The congested mucous membrane has lost part 
of its resisting power to germs ; the secretions are a net to catch the germs, 
and an incubator for their growth. To sum up, the obstructions prevent 
normal breathing, cause irritation, congestion, eatarrh, excess of secretion 
and invite infection. The nose and throat are the gateway from, through 

(14) 



and by which one's hearing is protected or destroyed. In the normal upper 
respiratory tract the air becomes warm and moist as it passes thiough the 
nose and the middle ear is ventilated with this air through the eustachian 
tube during the act of swallowing. In the obstructed nose (No. 1*,) during 
inspiration, the air is rarefied in the post nasal spaice*, making it not favor- 
able to middle ear ventilation; duiing the act of expiration, the pressure is 
slightly increased in the post nasal space*, which is favorable to ventilation 
of the middle ear through the tu])e, with the inipuie air coming from the 
lujiiis. In an acute cold (acute catarrh), one's nose is irritated and congest- 
ed, with an excess of secretions; this acute catarrh often exten;ls into 
the eustachian tube (No. 2*), swelling it shut thus preventing ventilation 
of the middle ear through the tube. 

This is a condition almost all have experienced duiing a severe cold: 
the ears felt as if they were stuffed with cotton, and a friend's clear 
cut voice seemed to be uuifHed. This is the typical condition found in child- 
ren with o])structive adenoids and tonsils. The catarrh of the nose and tube 
is not a.s sevei-e all the lime as in the acute cold, but the adenoids* or ton- 

SLIDE No. 11— 







Cold with Tonsilitis 

Abscess of the Ear and Earache. 



Fig. 11 — Front view of cross section shows results of cold and 
sore throat. The middle ear infected through the eustachian tulie, caus- 
ing abscess of ear, earache and bulging drum. 

sils* may ju-ess directly against the mouth* of the tube* preventing ven- 
tilation of the middle ear.* Then the air is partially absorbed in the middle 

(15) 



ear and the drum is pushed in by the greater air pressure on the outside 
of the drum, (see retracted drum*), which puts the drum on tension, mak- 
ing it less sensitive to little sound waves ; hence hearing is reduced. Child- 
ren in this condition take cold easily, which makes the ear troubles worse. 
This condition, after months or years, may produce a chronic catarrh of 
the ear that counts its victims in adult life by the thousands those not deaf 
but hard of hearing. The apparently inattentive child often, when grown 
up is afflicted with defective or greatly reduced hearing. 

These are not all the causes of defective hearing. Catarrh of the 
nose may extend through the eustachian tube* into the middle ear*, causing 
the mucous membrane to lose part of its resisting power. The catarrhal 
middle ear invites infection, the nose* and throat* are harboring infection, 
and the sufferer holds his nose and forcibly blows the infection through the, 
tube* into his ear*, planting the germs that often grow an abscess in the ear 

SLIDE No. 12.— 



Middle Ear, Drum AND Ossicles . 
Refrsded Drum Bulimy Drum 



Normal 




Perforated Drum 



Osside and part of 



Drum 






me 



Fig. 1 2. — Cross section of left middle eai". 

with the reward of temporary deafness and the nerve racking earache from 
pus and pressure behind the drum*. The pernicious habit of holding the 
nose and blowing up the ears is the price of ignorance of the relations of 
the physiology and physics of the nose and the ears. 

The eustachian tube is so large in some people that nasal obstruction 
and congestion do not close it. Every time they hold their nose, and forci- 

(16) 



bly blow, the tubes open, and if they have a septic post nasal catarrh, they 
frequently plant the disease in the ear. This should teach us to mufHe the 
handkerchief in the hand and hold it gently against the nose during the act 
of blowing, especially when suffering with colds or Grip. 

Fig 12 is a good synopsis of middle ear condition. With the Normal 
Drum^ is the normal ear with normal hearing; the other four have defective 
hearing. The Retracted Drum* is caused by want of ventilation through 
the eustachian tube. The air is partially absorbed in the middle ear and 
the drum* is pushed in by the greater air pressure on the outside of the drum 
thus putting the drum on a tension and making it less sensitive to the lit- 
tle sound waves; also the ossicles (Malleus*, Incus* and Stapes*) are pulled 
from their natural position, lessening their free and easy movements. The 
BuUjing Drum* is the result of an abscess* behind the drum, and the 
pressure is the cause of the earache and deafness. The Perforated Drum* 
is the result of the drum being weakened by the abscess, the pressure of the 
pus being thus able to perforate* the drum*, the beginning of the running 
ear. Ossicles and part of the Drum^ gone, are the result of a chronic run- 
ning ear which has destroyed the Incus and part of the drum.. 

There are only three facts to be ascertained in the examination of 
the ears of school children, all are illustrated on Slide No. 12. 

1. Is the pupil inattentive? — if so test each ear with the voice or a 
watch in a quiet i-oom to see if hearing is reduced. 

2. Does the pupil complain of earache? 

3. Does matter (pus) or odor proceed from the ear? 

Two facts to be ascertained by inspection of the nose and throat : 

1. (4). Has the pupil sniffles, frequent colds and discharge from 
the nose and throat? 

2. (5). Is the pupil a habitual mouth breather (with nasal voice) ? 
The above questions (except No. 3) are well illustrated in the fol- 
lowing group, Fig. 13. 

SLIDE No. 13.— 

This is a group of children at the training school of the State Normal 
and Industrial College of North Carolina, that today would likely be de- 
fective both physically and mentally, had it not been that their teachers 
upon inspection attributed their backwardness to some ear, nose, or throat 
trouble; referred them to the department of Pedagogy with class records 
and symptoms, which medical inspection proved to be true. Their parents 
were advised that their children had some ear, nose or throat trouble, and 
most of the parents called at the school for further information. 

(17) 




Fig 13, group of children suffering from hypertrophied adenoids 
and tonsils, mouth breathers. No. 1 — mouth breather and stammerer_ 
No. 2 — inattentive. No. 3 — head colds. No. 4 — earaches. No_ 5 — inat- 
tentive. 




Fig. 14, same as Fig. 13, five months after removal of adenoids 
and tonsils, demonstrates the effectiveness of inspection of the in- 
dividual "in the light of the eight fundamentals." The defects give 
symptoms. The symptoms suggest the cause. The cause found and 
removed, gives relief. 

(18) 



The parents of the children of this group took the advice seriously 
;ind had the defects 'lemoved, and have been rewarded by their children 
being put in the race to win, both physically and mentali>. 

In December 1910, their pictnres were taken. AU were operated 
upon (hu'iiig the holichiys or imniediatcdy afterwards. 

No. 1. School recor;! : Male, age 8. second year in school, iii lower 
Hist grade. 

Synijitoms: Has snifHes, colds, stammers, mouth b. cather, g^-nera. 
condition poor. Repoit of i)hysician : Large tonsils and adenoids. Treat- 
ment: Tonsi'.s and adenoids removed. May school report, 1911: Advanced 
lUdje ill live months than in one year and a half before operation. Now 
compare his physical condition which has improved equally as much. 

No. 2: School record: Male, age 11; fifth year in school, in iiltli 
grade; hard for him to make his giades; hearing not good, inattentive; 
mouth breather. Eeport of physician : Large tonsils and adenoids, catarrh 
of eustachian tubes and middle ears, poor ventilation through tubes, re- 
tracted drums, hearing for watch (right ear, 10 inches; left ear, 15 inches), 
Treatment: Tonsils and adenoids removed. May, 1911. Five months later : 
Hearing same watch and room, (right ear, 9 feet; left ear, 12 feet) hearing 
improved al)Out 1000 per cent. General condition changed fioni a Hook 
Worm tyjjc to a rosy cheeked lad. School report before ojieratinu : "Was 
hard for him to make his grades." After operation was never again senL 
t ^ office for failure to do work, gained 10 pounds in weight. How came these 
great changes? It was the result of nasal bieathing, plenty of air to thf- 
Inngs, more oxygen for the blood, re-e.stablishiirg the equilibrium of air, 
water arrd food,, which enabled him to make higher grades, because of his in- 
creased physical and nrental force. Nasal breathiirg cured his nasal, ens 
tachian and middle ear catarrh, the trrbes opened, re-established the venti 
lation of the middle ears, the drum returned to its normal position, his hear- 
ing became acute, he is rro longer corrsidered dull, inattentive or lazy, lie- 
cause the eight fundamentals are all working in harmony. 

No. 3. School record: Female; age 7; fiist year in school; iir lower 
first grade. Symptoms: Head colds. Rei>ort of physician: Large ton 
sils and adenoids. Treatment: Tonsils and adeiroids removed. May 
school report, five months later: Promoted to second grade, better atterr- 
dance, health improved. 

No. 4. School record: Female; age 10; third year irr school; sec- 
ond grade. Synrptoms: Earaches, mouth breather. Eeport of physician : 
V-shaped arch of hard palate; crowded teeth, aderroid facies and adenoids. 
Treatmerrt : Removed adenoids which were the indirect cause of the ear- 
aches arrd facial deformities. School report five months later: Proirroted 

(19) 



to third grade. Before operation, reports poor; after operation good and 
excellent; seems much stronger physically. 

No. 5. Female; age 8, third year in school, in first grade. Symp- 
toms : Hearing not good, inattentive. Report of physician : Large tonsils 
and adenoids; V-shaped arch, (no adenoid facies). Treatment: Tonsils 
and adenoids removed. School repoit five months later: Promoted to 
second grade, work much better, still inattentive because of habit acquired. 
Hearing for watch before operation— right ear 24 inches; left ear 20 inches. 
Hearing for watch after operation— right ear, 48 inches; left ear 40 inches. 
The inattentiveness is not from habit but because the hearing was so much 
impaired that it did not return to normal. The same watch and room were 
used as in testing No. 2. (Physician). 



Lecture No. 2. 

Eyes 

The conservation of the sight is by preventing injuries to the eyes by 
diseases and accidents; and also by protecting tJiem from the injuries of 
eye strain caused by the imbalance of the six pp^irs of muscles, or from the 
errors of refraction in farsightedness, near-sightedness, and astigmatism. 
These errors of refraction should be corrected with glasses prescribed by 
an oculist. 

SLIDE No. 3. Sight, the first in order and importance of 
the five special senses, is the accomplishment of the eye*, which is 
housed for protection in a bou}^ cavity on a cushion of fatty tissue in the 
front of the head, (a hint that our movement should always be forward), 
protected in front by elastic curtains (eye lids*) on whose edges are cilia, 
(eye lashes*) to bat away little particles of dust, dirt or small insects that 
would irritate or hurt the eye. Just over the eye is the lacrimal gland (a 
little spring) to keep the eye moist and washed clean. The tears are drained 
from the inner side* of the eye* through the nasal duct into the nose*, and 
when the eye is irritated or pained, the laeirimal gland opetis its flood gate 
to wash away anything that may be hurting the eye. Then the tears over- 
flow on the cheek* because the nasal duct is too small to cftrry the excess 
of tears. Sometimes the nasal duct becomes stopped up by disease or con- 
gestion in the nose* ; then the tears overflow even though tnfe eye is not 
painful. 

Porta, in 1560, compared the eye ball* to the "camera obscura", 
describing the working of the ciliary muscle, making the lense more eon- 
vex, focusing the 'rays of light Upon the retina, which by its visual purple 
could take, develop and transmit through the optic nerve a picture to the 
sight center* (area) in less than a second. But he did not suspect that this 

<20) 



little art studio (the eye*) in making optical pictures to be analyzed by the 
sight center* (area) in order that they may become treasures of the intel- 
lectual center*, (area) could or would draw upon the reserve forces of 
the nervous system to pay its defects of muscle inibalance, far-sightedness, 
near-sightedness, or astigmatism, and in this way make the nervous and 
physical system the indirect sufferers from eyeaches and headaches, loss of 
sleep and poor digestion. 
SLIDE No. 15— 



Nasal Cinify ^^—^^'^'d ^ 




Fig. l.j, head in position lo.oking at the noon-day snn. S'ection 
of left inferior rectus nuisele and optic nerve removed to show the 
superior rectus nuiscle. Only a part of inferior oblique muscle is shown. 

The human eyes are a double rapid kodak, each taking the same pic- 
ture simultaneously. 'I'o do this six pairs of mtiscles must keep each eye 
in the exact position to the same plane or field of vision as its fellow eye is 
in ; otherwise the i)icture of the same object on tlie t-etina of each eye would 
be interpreted by the biain as two objects, (called double vision). The six 
pairs of muscles have a dual function : First, the four pairs of recti, 
(straight) muscles (superior*, inferior*, internal* and external*) move 
the eyes up and down, right and left, enlarging the field of vision. Think 
of one trying to see if the eyes were stationary, moving the head instead of 
the eyes; second, the two pairs of (superior* and inferior*) oblique mus- 
cles that cross the eye balls toward the nose, and rotate the eyes simulta 

(21) 



neously on their anterior posterior axes (which axis is represented by the 
rays of light passing through the cornea to the retina in the next figure) 
work in harmony with the four* pairs of recti muscles, adjusting the verti- 
cal and horizontal axes to the plane of the field of vision. To illustrate, 
when the muscles of the right eye* are well balanced, the image of a verti- 
cal pole would be focused upon the vertical axis of the retina, and if the 
muscles of the left eye* are not well balanced the vertical axis of the retina 
would be oblique, causing the left eye to see the pole obliquely. The pole 
seen with the right eye would be vertical, with the left oblique. This con- 
fusion is overcome by taxing the oblique muscles* to do extra work to hold 
the veitical axis of both eyes in the same plane. One cause of eye strain 
is from muscle imbalance. The six pairs of muscles are the mechanical 
adjusters of the eyes, ^o that this double kodak enables the brain by its 
fusion and sight center; to give one picture to the intellectual center. The 
focusing apparati (the ciliary muscle and lense) of this double kodak woric 
simultaneously with the adjusting muscles. 



]Vo.l 



NORMAL EYES. 

Na 1 shows Adjusting and 
Focusing Apparati at Rest 
for Distant vision. 



No. 2 




Noi2.' Gonver^nce of eyes by the 
Adjusting muscles, and focusing for 
reading by the Ciliaiy muscles, 
making Lens more convex, as 
shovm by dotted lines. 



Fig. 16, No_ 1. The parallel lines represent rays of light re- 
fleeted from an object or emanating from a luminous .object at a 
distance of twenty feet or rnqre. The cornea and lense have the 
proper convexity for their distance in front of the retina to refract 
or bend the rays of light just enough to fiocus them iipon the retina. 
No. 2, the diverging lines represent rays of light reflected from words 
in a book at a distance of twelve inches. These diverging rays pass- 
ing through the cornea and lense must be bent more than the parallel 
rays to converge enough to focus them upon the retina, which is done 
by the action of the ciliiiry muscle making the lense more convex, as 
shown by the dotted Iv&^s. (22) 



The six pairs of adjusting mnselcs and the ciliary (focusing) mus- 
cles are at rest, when the normal eyes* (No. 1.) are looking at an object 
at a distance of twenty feet or more and the anterior, posterior, vertical and 
horizontal axes of each eye are each on the same plane with the corres- 
ponding axis in the other eye. Any kodak to take an intelligent picture 
must be adjusted for the space and focused for the distance. In the commer- 
cial kodak the focus is found by moving the lense to or from the film ; in 
the double human kodak, by the ciliary museles*. making the (elastic) 
lense* in the eye more or less convex, to focus the rays of light from the ob- 
ject upon the retina, (as shown by the dotted lines in No. 2*). Normal 
eyes (No. 1*) that have normal vision for objects at a distance of twenty 
feet or more when both the adjusting and focusing muscles are at rest, 
must change their adjustment and focus to see nearer or at a reading dis- 
tance. (No. 2*). This adjustment is made by the internal recti muscles 
two straight muscles next to the nose, converging the eyes for near vis- 
ion. This is easily demonstrated by having your desk mate look at a dis- 
tant object and then at a pencil six inches from the eyes, when you will see 
the cornea of each eye move towards the nose. In the young and middle 
aged the eyes are converged by the internal recti muscles, and simultaneous- 
ly the leuses* become more eonvex anteriorly (as illustrated by dotted lines* 
in No. 2) by the action of the ciliary muscles. The action of the ciliary 
muscles*, changing the lenses is known as accommodation*. (No. 2). 
Convergence and accommodation are controlled by the same nerves. There- 
fore, the harmonious working of the muscles to maintain the proper re- 
lations of convergence* and accommodation* (No. 2) in the normal eyes 
are performed unconsciously by the individual. The six pairs of adjust- 
ing and focusing muscles are verj^ active during school life, but are not pro- 
tected by the eight hour law to prevent them from over-work^some are on 
active duty nearer sixteen hours, and doing extras for defects of far-sighted- 
ness, near-sightedness, astigmatism or muscle imbalance. In the normal eye 
the ciliary muscle is only on duty when looking at objects nearer than 
twenty feet. 

SLIDE No. 17.— 

In the far-sighted eye* (short eye) the ciliary nuiscle* is on duty when 
looldng at objects more than twenty feet away to make the lense more con- 
vex to focus the rays of light upon the retina. The extra work is in 
proportion to the amount of far-sightedness, and this same extra work has 
to be done in looking at objects nearer than twenty feet. Then the ciliary 
muscles*, compensating for the far-sightedeness and accommodating foi- 
near work, may be doing 25, 50 or 100 per cent, more work than the ciliary 
nuiscles in the normal eye. Far-sighted children usually have normal dis- 

(23) 



Far-sigMed Eye. 



Bt}ilcd lines show 
action of Cilia ry Muscle . ^ 
mBkin§ Lens X 
more conmxS-^ \ //■ 

rafs of "~' ' 
on Refsna. 




Uehtm 



Foeu£> of 

bebmd &-e 
hieii Qiidf} mus- 
cle is at rest 



Fig. 17. 

tance vision 20-20. Those in good health have a reserve force to do thi,-i 
extra work without any inconvenience ; others who are working np to their 
full physical capacity are often sufferers of headaches, e3^eaches or blurred 
vision, especially in the afternoon, and may have red and infiamed eyes. 
SLIDE No. 18.— 



Normal Eye 




Fig. 18 shows the focal points for rays of light coming from 
objects twenty feet ,or more. The ciliary muscle and lense at rest. 

(24) 



Near sighted* (long eye) is the opposite of the far-sighted*. The 
rays of light are focused in front* of the retina* ; the ciliary muscle* is 
never over-worked l)nt is under worked, and if the near-sightedness is of 
high degree, it never does any work at all. Near-sighted* people's distant 
vision is always blurred and cannot read the 20-20 line on the chart at 
twenty feet. The strain in trying to see, pins the disturbance of the equili- 
brium of the accommodation and convergence, the accommodation working 
little or none, the convergence doing an excess of work when the book is 
brought near the eyes (accommodation and convergence should work simul- 
taneously), causes poor vision and often headaches in near-sighted people. 

Astigmatism is where the curvature of the cornea is not symmetrical, 
the curve of convexity being greater in one meridian than in the other. 
A derby hat is a good illustration, the top curving quicker from one side 
ix) the other than from before backwards. The rays of light passing 
through the meridian that curves quicker, focus in front of those that pass 
through the other meridian the lesser curve and the different curvatures of 
the cornea in its different meridian (or axis) cause different focal points of 
the rays of light passing through their meridians. When the accommoda- 
tion is adjusted for one meridian (or axis) the other is blurred. 

SLIDE No. 19.— 



n n 


•^i 


f*- 




1 5 


E R T 3? 


Z B D E F 


O 1" C Z B 1. 

O 2 A R r P 


rxvorsss. 



Fig. 19. The slide is very effective to illustrate the physics of 
the rays of light, which are absorbed, refracted or reflected. The 
astigmatic lense to illustrate the effect of astigmatism is a perfect 
demonstration of the evil effects of astigmatism. 

We have compared the eye to a double kodak (a receiving instru- 
ment) ; now we will call the lantern a projecting kodak because the picture 

(25) 



is in the machine and the object appears to be on the canvas. Those who 
now see this chart have a picture of it upon the retina of the eyes which 
is up-side down on the retina although interpreted by the retina, optic 
nerve, and sight center as an upright chart on the canvas. The seeing of 
the picture Avith the eyes is exactly the reverse of making it with the lantern. 
The slide is put in the lantern up-side down (the physics of light absorbed, 
refracted or reflected) the light behind the slide is absorbed and refracted, 
the rays of light falling upon the letters and lines on the slide are absorbed, 
therefore they are produced upon the canvas as shadows*. The rays of light 
passing through the slide around the letters and lines are refracted and fo- 
cused upon the canvas, thereby projecting the chart, which is made up of 
shadows* (letters) and light, on the canvas. The slide in the lantern 
up-side down and on the canvas top-side up, is proof that the light is re- 
fracted'. The rays of light falling on the letters are absorbed and the 
rays of light passing through the slide around the letters are refracted by 
the lenses, making letters upon the canvas by shadows and light. This 
light, which gives form to the letters (shadows) is reflected" to the eyes 
of the spectators, is refracted as it passed through the cornea and the 
lense of the eye, and is focused upon the retina of the eye up-side down as 
it is now in the lantern. This projecting chart is made by adjusting the 
lantern* to the canvas, then focusing the rays of light upon the canvas, 
which are refracted by the lenses in the machine. This equals the normal 
eye. To shorten the lantern by moving the lenses nearer the slide (lantern's 
retina) would make it far-sighted; to lengthen the lantern by moviug the 
leuse farther from the slide would make it near-sighted. 

Astigmatism as has been illustrated by the "hat" is where a surface 
(?urves quicker in one meridian than in its opposite meridian. Cylindrical 
lenses (astigmatic lenses) are of two kinds : convex (plus), concave (minus). 
The plus cylinder is flat on one side and on the opposite side isi 
convex in one direction or axis. The first slab sawed off of a log is a good 
Illustration. The sawed side is flat, the side covered with the bark is curved 
from side to side. The log is a cylinder, the slab is a segment of the cylin- 
der. If the slab were a piece of glass two inches wide and twelve inches 
long, we could cut an astigmatic lense out of it like the lense we will now use. 

1. The reversfil of the Chart from the lantern to the canvas is 
caused by the convex lenses in the lantern deviating the rays of light 
that have passed through the slide to the oppiosite side. The bending of 
the rays bv the convex lenses to cross to the opposite side is refract- 
ing; the placing of them at the corresponding place on the opposite 
side of the picture is by focusing. 

2. The rays of light from the lantern thrown upon the canvas are 
reflected to the spectators in proportion to the intensity of the light 
and the ability of the canvas to reflect the rays,, thus the spectators 
see the chart of shadows and lisrht. If the light were thrown upon a 
mirror adl the raj^s would be reflected. 

(26) 



except this lense has a much lesser curve. This lense does not converge the 
rays of light to a focal point but makes a line of light. To put the lense in 
front (against) the machine makes it astigmatic, as is now demonstrated, 
blurring part of the clock face, because the lantern has astigmatism. 

This astigmatic lense occupies the same position to the lantern as 
the astigmatic cornea does to the eye, as it curves quicker in one direction 
than the other. Therefore, the lays of light passing through the quicker 
curve are focused just in front of the canvas, causing blurring of part of 
the clock face. By rotating the lense in front of the machine we make it ver- 
tical*, oblique* or horizontal* astigmatism. (The oblique is the worst be- 
cause it blurs and makes the letters appear obique*). This is the way a per- 
son who has astigmatism sees the chart. Without the lense the machine equals 
the normal eye. Leave the lense on and make the machine shorter, it equals 
the farsighted eye with astigmatism. Now make the machine longer, and 
it equals the near-sighted eye with astigmatism. 



FACTS TO BE ASCERTAINED IN EXAMINING SCHOOL 

CHILDREN 

1. Does the pupil suffer from intiamed lids or eyes? Eye strain 
often causes inflamed lids and eyes with little or no secretion. Acute con- 
junctivitis (Pink eye) causes red lids and eyes with secretion and pus; is 
contagious, but easy to cure. Granulated lids (Trachoma) is the most fre- 
quent cause of chronically inflamed lids and eyes with secretions and pus; 
is contagious and hard to cure. 

2. Does the pupil fail to read a majority of the letters in line No. 20 
with either eye at 20 feet ? Near-sightedness and astigmatism are the most 
frequent causes of defective vision in question No. 2. 

3. Do the eyes or head frequently grow tired and painful after 
studying, especially in the afternoon, with or without blurring when read- 
ing? Eye strain for want of glasses is usually the cause of symptoms in 
No. 3. 

4. Does the pupil appear to be cross eyed? This is some times the 
result of eye strain, far-sightedness, muscle imbalance and oblique astig- 
matism. 

Slide 3 — Smell, (nose*) ; 2'aste, (mouth*) ; Touch, (hand*), have not 
been considered. The olfactory sense or sense of smell is essential to guard 
us against bad air and food ; it is also an auxiliary to the taste by exciting the 
appetite for the expected food, and doubles the pleasure of eating by the 
savor of its odors, thereby aiding digestion. 

Taste has four qualities — bitter, sweet, sour and salty, with ap- 
preciation of the flavors of the food gives the pleasure in eating. Taste is 

(27) 



a great aid to digestion by stimulating the flow of saliva and the digestive 
juices. Hunger increases the enjoyment of eating usually in the same pro- 
portion to its demands for relief. Taste through the demands of hungc- 
becomes an executive power in issuing orders for food and drink to be used 
in the metabolism (growing and repairing) of the human body. It is the 
duty of every one to educate his taste to choose food and drink that will 
build a strong and well balanced house for the mind. How unfortunate 
are those who have trained the taste to submit and become so subdued that 
it enjoys the aroma with the sting of nicotine in the cigar ; although, when 
the poisonous weed was first indulged in, the system gave signals of distress. 
the forehead was moist with perspiration, the muscles too weak to work, the 
stomach turned over and heaved as if in distress on a high sea, yet with all 
this, many would have you believe that smoking and chewing is the satis- 
faction of natural taste. 

Touch consists of both sensory and tactile sense. The sensory sense 
is a thermometer to warn us against the dangers of heat and cold ; it also re- 
ports any injuries to the body. 

The tactile sense is used as a utility sense for the eyes and ears by 
the blind and deaf which shows us how highly this sense can be educated. 
The educated touch of the trained physician 's fingers is so highly developed 
that its diagnostic powers see beneath the surface, discovering diseases that 
can not be seen by the eye ; by the touch of the pulse the working of the 
heart is known. The musician's touch on the piano keys tell you in a mo- 
ment of the skill of the performer. The touch of the mother 's kiss cures the 
aches of the little one's heart. 

For the teacher to understand the physics, physiology and anatomy 
of the eye, ear, nose and throat, is more a luxury than a necessity in making 
examinations. A positive answer to one or more of the nine questions indi- 
cates that the child has a defect that needs medical attention. These defects 
are so noticeable that a layman by simple test can detect them; impaired 
vision, bad hearing, poor health or suffering with pain. 

Dr. Frank Allport has worked out a test chart with instructions that 
are so clear and plain that any teacher can make these examinations and be 
protected from criticism for want of accuracy. The last revision of the chart 
enables the teacher to examine the eyes of first grade pupils by having them 
to indicate by the hand or letter the position of the " E ". 

These examinations carefully done by the teachers will find from 5 to 
15 per cent, of the pupils with defects of the ear, nose or throat, and from 
5 to 15 per cent, with defective eyes. Trained physicians making these in- 
spections will increase the percentage. Schools that have been inspected and 
treated wi-U decrease the percentage. 

(28) 



Instructions for Examination of Sciiool Giiiidren's Eyes and Ears 

FOn USE OF PRINCIPALS, TEACHERS, ETC, 

(Courtesy of Dr. Frank Allport) 



Do not expose the eard except when in use, as faniiliarity witli its face 
leads children to learn its letters "by heart". 

The exanimatious should be made privately and singly. 

Children already weaiing- glasses should be tested with such glasses 
properly adjusted on the face. 

riace the "Vision Chart for Schools'' (Snellen's) on the wall in a 
good light; do not aliow the face of the card to be covered with glass. 

The line marked 20 should be seen at twenty feet, therefore place 
the pupil twenty feet from the card. 

Each eye should be examined separately. 

Hold a card over one eye while the other is being examined. Do not 
press upon the covered eye, as the pressuie might induce an incorrect ax- 
amination. 

Have the pupil begin at the top of the test card and read aloud down 
as far as he can, first with one eye and then with the other. 

For the use of those children not knowing the names of letters, the 
sign ( uu ) has been placed on each line in various positions. The child 
should indicate in which position this sign is placed. A card board symbol 
( Lu ) can be easily cut out, which the child can hold in its hand. It should 
hold the figure in the same position as the one it is expected to see on the 
Chart. For the purpose of convenience each line ends with the sign ( uj ) 
in various positions. 

Facts to be|Ascertained 

1. Does the pupil habitually suffer from inllairred lids or eyes? 

2. Does the pupil fail to read a majority of the letters in the number 
20 line of the Snellen 's Test Types, with either eye ? 

3. Do the eyes and head habitually grow weary and painful after 
study ? 

4. Does the pupil appear to be "cross-eyed?" 

5. Does the pupil complain of earache in either ear? 

6. Does matter (pus) or a foul odor proceed from either ear? 

7. Does the pupil fail to hear an ordinary voice at twenty feet in 
a quiet room ? Each ear should be tested by having the pupil hold his haird 
over first one ear, and then the other. The pupil should close his eyes dur- 
iirg the test. 

8. Is the pupil frequently subject to "colds in the head?" and dis- 
charges from the irose and throat? 

9. Is the pupil an habitual "mouth breather?" 

If an affirmative answer is found to any of these questions, the pupil 
should be given a printed card of warning to be handed to the parent, which 
should read something like this : 

(29) 



o 



o 

10 



Q 

W 

O 

O 

m 



i72 



Q 



02 










o 
Pi 



o 

CO 

E 

n 

3 



o 

CM 

n 
o 

E 



o 






03 



.S 
^ 

H 



CARD OF WARNING TO PARENTS 

After due consideration it is believed that your child has some Eye, Ear, 
Nose and Throat disease, for which your family physician or some specialist should 
be at once consulted. It is earnestly req.uested that this matter be not neglected. 

Respectfully, 



School 



If only an eye disease is suspected, the words "ear, nose and throat" 
should be crossed off; if only an ear disease is suspected, the words "eye, 
nose and throat" should be crossed off; if it is only a nose and throat dis- 
ease, the words ' ' eye and ear ' ' should be crossed off. 

It will be observed that these cards are non-obligatory in their nature 
They do not require anything of the parent, who is at perfect liberty to take 
notice of the warning card or not, as he sees fit. They simply warn the par- 
ent that a probable disease exists, thus placing the responsibility upon the 
parent. 

Nevertheless, if parents neglect the warning thus conveyed, the teach- 
er should, from time to time, endeavor to convince such parents of the ad- 
visability of medical counsel. Teachers are urged to impress upon pupils 
and parents the necessity for consulting reputable physicians. 

These tests should be made annually at the beginning of the Fall 
term. 

Each teacher should examine all the children in his or her own room, 
and should report the results of such examinations to the principal, such 
report to be signed by the examining teacher. 

The following simple form of report, to be filled out by the teacher 
and handed to the principal, is sugegsted and may be printed upon paper 
of any size and character that is deemed advisable by the local school au- 
thorities, and should be distributed to the different room teachers. 



No. 


NAME OF PUPIL 


Do the tests indicate an Eye, Ear, 

Nose or Throat Disease? 

Answer "Yes" or "No" 

If so, which? 


Was the pupil 
given a Card 
of Warning? 



















































(32) 



The sanitation of air, water and food is not in the scope of these lec- 
tures ; neither is the diagnosis or treatment of any of the defects or diseases 
of the five special senses, for all of these are specialties within themselves. 

Slide 1. But the eight fundamentals* to grow the physical and intel- 
lectual life should be so indelibly stamped upon the teacher's mind, that she, 
by checking them up one by one, by lobservation or examination, will in most 
cases find the defective link. Then it is her duty to advise the parent if 
possible to have the defect corrected. These examinations for the eye, ear, 
nose and throat in the school room are few, simple and accurate. The great 
trouble is that many teachers try to find the defects through a misty under- 
standing of much reading of the subject, where the writer put just enough 
statistic, technical, medical and physiological terms in it to make it confus- 
ing instead of impressing the fact, that a dozen backward children may be 
thus from as many different causes. Not to study them collectively, but 
each individually gives the best results. If our deductions are correct 
that all physical and intellectual life is the growth of, by, or through the 
eight* fundamentals, and that the examinations for defects of the eye, ear. 
nose and throat are few, simple and accurate, consisting of nine questions, 
to be ascertained by observation or simple tests to see if the eight fundamen- 
tals are normal and performing their function without detriment to the 
others; when those nine questions to ascertain eye, ear, nose and throat 
defects have been checked up and found to be negative, remembering that 
anything that weakens the physical body, usually in the same proportion 
weakens the metal ability ; then be on the alert for other causes that likewise 
retard the child's progress from the first to the tenth grade, (provided it 
ever makes the tenth.) Some of these children are never sick, or never 
strong, but may be sufferers of tuberculosis, malaria or hook worm. So 
great have been their damages that the Government and Philanthropists 
are helping to fight these diseases, until they are exterminated. We want to 
know how they disturb the equilibrium of the eight fundamentals, and how 
to prevent their doing so. The health officers and physicians must look 
after the sanitation and treatment. 

SLIDES (to illustrate tuberculosis as selected by the lecturer). 

Tuberculosis injures or destroys the lungs, the medium for exchange 
of carbon-dioxide in the blood for the oxygen in the air— another way of 
starving the system for oxygen and at the same time poison the system with 
a toxin, causing fever. Tuberculosis can be prevented only in two waj^s: 
First, by the prevention of infection ; second, by keeping our health in a con- 
dition that will resist infection. When sanitation has reached the point 
of perfection that we do not breathe, eat, or drink the tubercle bacilli, then 
new cases mil cease to develop, and the old ones will meet an untimely death 
or be cured by building up the health so that it will overcome the disease. 
Sum up preventable tuberculosis, where one is exposed, and we find it to 

(33) 



be in one's resisting power. This resisting: power is the physical force of 
the tissue of the body, which is the final product of the air breathed into 
the lungs, where the red blood corpuscles rob the air of its oxygen and carry 
it away through the circulation of the blood and turn it loose in the tis- 
sues. The food in the digestive tract liquefied with water, where with the 
digestive juices the process of digestion begins and is carried on to comple- 
tion by a partial or complete oxidation by the oxygen that is now in the tis- 
sue. These processes of digestion and metabolism give to every tissue and 
organ in the body the necessary substance to repair its waste or promote its 
growth, creating heat and storing up energy. It is a known fact that when 
one's health is below normal it is favorable soil for infection and disease, 
especially when exposed to infection. On the other hand some have such 
a fine constitution (resisting power) that they are practically immune to 
infection or disease. The treatment of tuberculosis is by building up the 
system to such a resisting power that it will not only prevent infection, but 
actually cure tuberculosis. This great crusade against disseminating infec- 
tion by sputa or other secretions cannot be too much agitated nor too close- 
ly observed. The open air treatment is beginning to be appreciated by the 
laity as a preventative for tuberculosis. Some are opening their windows; 
others sleep in the open, where they breathe fresh air, which means more 
oxygen in the lungs, blood and system, resulting in better health, and good 
health is our best prevention Avhen exposed to infection. Then let us urge 
that more follow the example of the few, and breathe pure air while they 
sleep, instead of sleeping in a poorly ventilated room, waking with a stuffy 
head caused by poor digestion and metabolism, and in some cases actually 
suffering with an auto-intoxication from a heavy supper with just enough 
oxygen during the night for partial digestion or oxidation. Instead of 
completing the beautiful cycle of the process of digestion, recuperating the 
system, feeling refreshed on waking, they begin a new day with a tired feel- 
ing, stuffy head and no appetite, the result of auto-intoxication from poor 
digestion and assimilation, which has just about enough oxygen during the 
night to reach the stage of fermentation or decomposition. Many who retire 
at night to rest their tired muscles find it necessary to get out before break- 
fast into the air, to wear off a headache or create an appetite. The house- 
keeper next morning throws open the windows to ventilate the rooms. The 
inmate must get out into the air to ventilate and disinfect his system, by an 
excess of oxygen passing into the lungs and system oxidizing the poisons ac- 
cumulated in his body during the night. 

SLIDES (to illustrate Malaria as selected by the lecturer). 

Malaria is carried from one person to another by the anapholes mos- 
quito. These mosquitoes have been called house or town mosquitoes be- 
cause old buckets, barjels or cisterns are favorite breeding places for them, 

(34) 



and they usually stay within a few hundred feet of their hatching places; 
in this way every country home grows its own pest. 

The mosquito prefers rich, red blood for his lunch ; therefore, good 
liealth is not a preventative for malaria. The prevention is to keep the in- 
fected mosquito from biting you. If it were possible and practical to isolate 
the malaria patient or comi)letely exterminate the mosquito, then the well 
would be protected against malaria. Parents and teachers should know that 
the malarial germs destroy the red blood cells which carry the oxygen of the 
air from the lungs throujidi the blood to the tissues, and in this way the sys- 
tem suffers for oxygen even though plenty is breathed into the lungs, 
At the same time malarial germs poison the system with toxins that are of- 
ten sufficient to cause chills and fever in some, in others a tired, run-down 
condition. 

The prevention is to destroy the mosquito's laboratory of supply by 
treating the malaria patient, and protecting him from mosquitoes by screens, 
especially at night, to prevent infection of mosquitos by biting the patient. 
This will also protect the rest of the family. Prevent the breeding of mos- 
quitos near the house by covering rain barrels, cisterns, etc., and drain ditch- 
es, ponds and puddles of stagnant water, or sprinkle these places every ten 
days and after a rain with kerosene oil, to prevent the hatching of the mos- 
quitoes. Protect yourselves by screens and nets at night in a malarial dis- 
trict, as this is the time the malaria mosquito is out. 

SLIDES (to illustrate hook worm as selected by the lecturer). 

Hook worm so deranges the digestion and metabolism that good food, 
pure water, and fresh air count for little to develop the system. 

It is both preventab'e and curable. The prevention, is by obeying 
sanitary laws. The diagnosis should always be confirmed by the physician's 
microscope, and the treatment directed by the physician. The disease is 
particularly prevalent in the sandy sections in the Southern States. 

The Eockefeller hook worm commission is doing much to eradicate 
the disease. 

Add these three diseases— tuberculosis, malaria and hook worm, to 
the nine questions on school inspection and by cancellation, often you wil! 
find why a pupil is not promoted. 



(35) 



mn 3 1912 



LIBRARY OF CONGRESS 



021 331 060 4 



LIBRARY OF CONGRESS < 

021 331 060 I- 



